Topic Contents

Diarrhea, Age 11 and Younger

Topic Overview

Diarrhea occurs when there is an
increase in the frequency of bowel movements or bowel movements are more watery
and loose than normal. Diarrhea has many causes.

Dietary changes

A child may develop diarrhea from a
change in his or her diet. A baby's or child's digestive tract may not tolerate
large amounts of juice, fruit, or even milk. Diarrhea may be caused by an
increase in the amount of juice or fruit a child drinks or eats. Diarrhea that
is caused by a change in the child's diet is not usually serious.

Infection

Diarrhea is often caused by a viral or
bacterial infection, such as
rotavirus, stomach flu (gastroenteritis), or
food poisoning. Diarrhea is the body's way of quickly
clearing any viruses, bacteria, or toxins such as
botulism from the digestive tract. Most cases of
diarrhea are caused by a viral infection and will usually clear up in a few
days.

Diarrhea may also be caused by a parasitic infection, such as
Giardia lamblia. This parasite, as well as other viral
and bacterial infections, may be spread by drinking
untreated water, unpasteurized dairy products, or by
poor hand-washing.

Other causes

On rare occasions, diarrhea can be a
symptom of a more serious condition, such as:

Children, especially those younger than 6 months of age
and those with other
health risks, need special attention when they have
diarrhea because they can quickly become
dehydrated. Careful observation of your child's
appearance and how much fluid he or she is drinking can help prevent
problems.

Normal stool during infancy may be runny or pasty, especially if the baby is
breastfed. The presence of mucus in the stool is not uncommon. Unless there is
a change in your baby's normal habits, loose and frequent stools are not
considered to be diarrhea.

More than a few drops. Blood is mixed in with the stool, not just on the surface.

More than a few drops of blood on stool or diaper

A few drops on the stool or diaper

A few drops of blood in stool or diaper

Do you think your baby has a fever?

Yes

Fever

No

Fever

Did you take a rectal temperature?

Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.

What you are looking for is a change in your child's usual bowel habits.

Diarrhea means that the
child is having more stools and looser ones than usual.

Constipation means that the child is having fewer stools than
usual.

Every baby and child has different bowel habits. What is
"normal" for one child may not be normal for another. In general:

Many newborns have at least 1 or 2 bowel movements a day. By the end of their first week, they may have as many as 5 to 10 bowel movements a day. They may pass a stool after each feeding.

By 6 weeks of age, your baby may not have a bowel movement every day. This usually isn't a problem as long as the baby seems comfortable and is growing as expected, and as long as the stools aren't hard.

By about 4 years of age, it's normal for a child to have as many as 3 bowel movements a day or as few as 3
a week.

Anywhere in these ranges can be considered normal if the habit
is normal or usual for your child.

Severe dehydration means:

The baby may be very sleepy and hard to wake
up.

The baby may have a very dry mouth and very dry eyes (no
tears).

The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

The baby may have no wet diapers in 6 hours.

The
baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

The baby may pass a little less urine than usual.

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever.

Symptoms of dehydration can range from mild to
severe. For example:

The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
dehydration).

The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
dehydration).

It is easy for your diabetes to become out of control when
you are sick. Because of an illness:

Your blood sugar may be too high or too
low.

You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).

You may
not know how to adjust the timing or dose of your diabetes
medicine.

You may not be eating enough or drinking enough
fluids.

Symptoms of serious illness may
include:

A severe headache.

A stiff
neck.

Mental changes, such as feeling confused or much less
alert.

Extreme fatigue (to the point where it's hard for you to
function).

Shaking chills.

A baby that is extremely sick:

May be limp and floppy like a rag
doll.

May not respond at all to being held, touched, or talked
to.

May be hard to wake up.

A baby that is sick (but not extremely
sick):

May be sleepier than usual.

May not eat
or drink as much as usual.

Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature.

Oral (by mouth), ear, or rectal temperature

High:
104°F (40°C) and
higher

Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)

Mild:
100.3°F (37.9°C) and
lower

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Armpit (axillary) temperature

High: 103°F (39.5°C) and higher

Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)

Mild: 99.3°F (37.3°C) and lower

Note: For children under 5 years old, rectal temperatures are
the most accurate.

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar.

A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black.

If you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

Symptoms of serious illness in a baby
may include the following:

The baby is limp and floppy like a rag doll.

The baby doesn't respond at all to being held, touched, or talked
to.

The baby is hard to wake up.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms
and arrange for care.

If you cannot reach your doctor or you don't
have one, seek care today.

Home Treatment

Newborns and babies younger than 1 year of age

Don't
wait until
you see signs of dehydration in your baby. These signs include your baby being thirstier than usual and having less urine than usual.

If you breastfeed your baby, nurse him or her
more often. Offer each breast to your baby for 1 to 2 minutes every 10 minutes.

If you use a bottle to feed your baby, increase the number of feedings to make up for lost fluids. The amount of extra fluid your baby needs depends on your baby's age and size. For example, a newborn may need as little as 1 fl oz (30 mL) at each extra feeding, while a 12-month-old baby may need as much as 3 fl oz (90 mL) at each extra feeding.

Ask your doctor if you need to use an
oral rehydration solution (ORS) if your baby still isn't getting enough fluids from formula or the breast. The
amount of ORS your baby needs depends on your baby's age and size. You can give the ORS in a dropper, spoon, or
bottle.

If your baby has started eating cereal, you may replace
lost fluids with cereal. You also may feed your baby strained bananas and
mashed potatoes if your child has had these foods before.

Children ages 1 through 11

Make sure your child is drinking often.
Frequent, small amounts work best.

Allow your child to drink as much fluid as he or she wants.
Encourage your child to
drink extra fluids or suck on flavored ice pops, such as Popsicles. Note: Do not give your child fruit juice or soda pop. Fruit juice and soda pop contain too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Diet soda pop lacks calories that your child needs.

Cereal mixed with milk or water may also be
used to replace lost fluids.

Symptoms to watch for during home treatment

Signs of dehydration
develop. These include your child being thirstier than usual and having less urine than usual.

Your child has diarrhea and a fever.

Symptoms become more severe or frequent.

Prevention

Do not allow your child to drink
untreated or unfiltered water from a lake or stream or unpasteurized milk.
Untreated water and unpasteurized milk are sources for viral, bacterial, and
parasitic infections, such as
Giardia lamblia. Avoid having your child brush his or
her teeth with untreated water. Even a small amount of untreated water can
contain enough parasites, virus, and bacteria to cause diarrhea.

Be sure to wash your hands and your child's
hands after each diaper change or trip to the bathroom.

Teach your
child to wash his or her hands after using the bathroom and before every
meal.

Do not place soiled diapers on surfaces that are used to
prepare or serve food.

If your child attends school or day care, keep your
child at home until your doctor has determined that his or her diarrhea can't be
passed to others (is not infectious).

Food poisoning is a common cause of diarrhea in children and
adults. Most cases of food poisoning at home may be prevented by taking a few
precautions when preparing and storing food. Perishable foods, such as eggs,
meats, poultry, fish, shellfish, milk, and milk products, should be treated
with extra care. Also, precautions should be taken if you are pregnant, you
have an
impaired immune system or a chronic illness, or you
are preparing foods for other high-risk groups, such as young children or older
people.

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